A Reinforcement Learning System to Encourage Physical Activity in Diabetes Patients
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Abstract (arXiv)
Regular physical activity is known to be beneficial to people suffering from diabetes type 2. Nevertheless, most such people are sedentary. Smartphones create new possibilities for helping people to adhere to their physical activity goals, through continuous monitoring and communication, coupled with personalized feedback. We provided 27 sedentary diabetes type 2 patients with a smartphone-based pedometer and a personal plan for physical activity. Patients were sent SMS messages to encourage physical activity between once a day and once per week. Messages were personalized through a Reinforcement Learning (RL) algorithm which optimized messages to improve each participant's compliance with the activity regimen. The RL algorithm was compared to a static policy for sending messages and to weekly reminders. Our results show that participants who received messages generated by the RL algorithm increased the amount of activity and pace of walking, while the control group patients did not. Patients assigned to the RL algorithm group experienced a superior reduction in blood glucose levels (HbA1c) compared to control policies, and longer participation caused greater reductions in blood glucose levels. The learning algorithm improved gradually in predicting which messages would lead participants to exercise. Our results suggest that a mobile phone application coupled with a learning algorithm can improve adherence to exercise in diabetic patients. As a learning algorithm is automated, and delivers personalized messages, it could be used in large populations of diabetic patients to improve health and glycemic control. Our results can be expanded to other areas where computer-led health coaching of humans may have a positive impact.
Key facts. Cited by 38 papers in the map (data through 7 Oct 2026). First posted on arXiv 13 May 2016.
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Citing papers per year: 2021: 5; 2022: 6; 2023: 12; 2024: 8; 2025: 5; 2026: 2.
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- 2021Fairness for Unobserved Characteristics: Insights from Technological Impacts on Queer Communitiescited by 40
- 2021Statistical Inference with M-Estimators on Adaptively Collected Datacited by 40
- 2022Designing Reinforcement Learning Algorithms for Digital Interventions: Pre-implementation Guidelinescited by 22
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- 2024Peeking with PEAK: Sequential, Nonparametric Composite Hypothesis Tests for Means of Multiple Data Streamscited by 9
- 2024The Last JITAI? Exploring Large Language Models for Issuing Just-in-Time Adaptive Interventions: Fostering Physical Activity in a Conceptual Cardiac Rehabilitation Settingcited by 7
- 2025SOMBRL: Scalable and Optimistic Model-Based RLcited by 7
- 2022Reinforcement Learning in Modern Biostatistics: Constructing Optimal Adaptive Interventionscited by 6
- 2023Semi-parametric inference based on adaptively collected datacited by 6
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- 2021Personalization Paradox in Behavior Change Apps: Lessons from a Social Comparison-Based Personalized App for Physical Activitycited by 2
- 2021Using Cognitive Models to Train Warm Start Reinforcement Learning Agents for Human-Computer Interactionscited by 1
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- 2023Designing and evaluating an online reinforcement learning agent for physical exercise recommendations in N-of-1 trialscited by 0
- 2023Adaptive Interventions with User-Defined Goals for Health Behavior Changecited by 0
- 2024Investigating Gender Fairness in Machine Learning-driven Personalized Care for Chronic Paincited by 0
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- 2026Exploring Reinforcement Learning for Fluid Transitions Between Clinical Mental Healthcare and Everyday Wellness Support5 Jun 2026
- 2026Reinforcement Learning in the Real World: A Survey of Statistical Challenges and Future Directions21 Jan 2026
- 2025SOMBRL: Scalable and Optimistic Model-Based RL25 Nov 2025
- 2025Bernstein-von Mises for Adaptively Collected Data10 Nov 2025
- 2025Diabetes Lifestyle Medicine Treatment Assistance Using Reinforcement Learning19 Oct 2025
- 2025Adaptive Off-Policy Inference for M-Estimators Under Model Misspecification17 Sep 2025
- 2025Enhancing Offline Model-Based RL via Active Model Selection: A Bayesian Optimization Perspective17 Feb 2025
- 2024A Deployed Online Reinforcement Learning Algorithm In An Oral Health Clinical Trial3 Sep 2024
- 2024Oralytics Reinforcement Learning Algorithm19 Jun 2024
- 2024Sample Efficient Myopic Exploration Through Multitask Reinforcement Learning with Diverse Tasks3 Mar 2024
- 2024Investigating Gender Fairness in Machine Learning-driven Personalized Care for Chronic Pain29 Feb 2024
- 2024reBandit: Random Effects based Online RL algorithm for Reducing Cannabis Use27 Feb 2024
26 more
- 2024Monitoring Fidelity of Online Reinforcement Learning Algorithms in Clinical Trials26 Feb 2024
- 2024The Last JITAI? Exploring Large Language Models for Issuing Just-in-Time Adaptive Interventions: Fostering Physical Activity in a Conceptual Cardiac Rehabilitation Setting13 Feb 2024
- 2024Peeking with PEAK: Sequential, Nonparametric Composite Hypothesis Tests for Means of Multiple Data Streams9 Feb 2024
- 2023Adaptive Interventions with User-Defined Goals for Health Behavior Change16 Nov 2023
- 2023Designing and evaluating an online reinforcement learning agent for physical exercise recommendations in N-of-1 trials25 Sep 2023
- 2023Adaptive Multi-Agent Deep Reinforcement Learning for Timely Healthcare Interventions20 Sep 2023
- 2023PDRL: Multi-Agent based Reinforcement Learning for Predictive Monitoring19 Sep 2023
- 2023Dyadic Reinforcement Learning15 Aug 2023
- 2023Online learning in bandits with predicted context26 Jul 2023
- 2023Adaptive Linear Estimating Equations14 Jul 2023
- 2023Assessing the Impact of Context Inference Error and Partial Observability on RL Methods for Just-In-Time Adaptive Interventions17 May 2023
- 2023Did we personalize? Assessing personalization by an online reinforcement learning algorithm using resampling11 Apr 2023
- 2023Semi-parametric inference based on adaptively collected data5 Mar 2023
- 2023Synthetic Data Generator for Adaptive Interventions in Global Health3 Mar 2023
- 2023Improving Fairness in Adaptive Social Exergames via Shapley Bandits18 Feb 2023
- 2022Reward Imputation with Sketching for Contextual Batched Bandits13 Oct 2022
- 2022Reward Design For An Online Reinforcement Learning Algorithm Supporting Oral Self-Care15 Aug 2022
- 2022Designing Reinforcement Learning Algorithms for Digital Interventions: Pre-implementation Guidelines8 Jun 2022
- 2022Optimal service resource management strategy for IoT-based health information system considering value co-creation of users5 Apr 2022
- 2022Reinforcement Learning in Modern Biostatistics: Constructing Optimal Adaptive Interventions4 Mar 2022
- 2022Counterfactual inference in sequential experiments14 Feb 2022
- 2021Bandit Algorithms for Precision Medicine10 Aug 2021
- 2021Statistical Inference with M-Estimators on Adaptively Collected Data29 Apr 2021
- 2021Using Cognitive Models to Train Warm Start Reinforcement Learning Agents for Human-Computer Interactions10 Mar 2021
- 2021Fairness for Unobserved Characteristics: Insights from Technological Impacts on Queer Communities3 Feb 2021
- 2021Personalization Paradox in Behavior Change Apps: Lessons from a Social Comparison-Based Personalized App for Physical Activity25 Jan 2021
- 2021Fairness for Unobserved Characteristics: Insights from Technological Impacts on Queer Communitiescited by 40
- 2021Statistical Inference with M-Estimators on Adaptively Collected Datacited by 40
- 2022Designing Reinforcement Learning Algorithms for Digital Interventions: Pre-implementation Guidelinescited by 22
- 2022Reward Design For An Online Reinforcement Learning Algorithm Supporting Oral Self-Carecited by 18
- 2022Counterfactual inference in sequential experimentscited by 13
- 2021Bandit Algorithms for Precision Medicinecited by 12
- 2024A Deployed Online Reinforcement Learning Algorithm In An Oral Health Clinical Trialcited by 11
- 2024Peeking with PEAK: Sequential, Nonparametric Composite Hypothesis Tests for Means of Multiple Data Streamscited by 9
- 2024The Last JITAI? Exploring Large Language Models for Issuing Just-in-Time Adaptive Interventions: Fostering Physical Activity in a Conceptual Cardiac Rehabilitation Settingcited by 7
- 2025SOMBRL: Scalable and Optimistic Model-Based RLcited by 7
- 2022Reinforcement Learning in Modern Biostatistics: Constructing Optimal Adaptive Interventionscited by 6
- 2023Semi-parametric inference based on adaptively collected datacited by 6
12 most cited of 37 All 37 (JSON)
- 2026Exploring Reinforcement Learning for Fluid Transitions Between Clinical Mental Healthcare and Everyday Wellness Support5 Jun 2026
- 2026Reinforcement Learning in the Real World: A Survey of Statistical Challenges and Future Directions21 Jan 2026
- 2025SOMBRL: Scalable and Optimistic Model-Based RL25 Nov 2025
- 2025Bernstein-von Mises for Adaptively Collected Data10 Nov 2025
- 2025Diabetes Lifestyle Medicine Treatment Assistance Using Reinforcement Learning19 Oct 2025
- 2025Adaptive Off-Policy Inference for M-Estimators Under Model Misspecification17 Sep 2025
- 2024A Deployed Online Reinforcement Learning Algorithm In An Oral Health Clinical Trial3 Sep 2024
- 2024Oralytics Reinforcement Learning Algorithm19 Jun 2024
- 2024Sample Efficient Myopic Exploration Through Multitask Reinforcement Learning with Diverse Tasks3 Mar 2024
- 2024Investigating Gender Fairness in Machine Learning-driven Personalized Care for Chronic Pain29 Feb 2024
- 2024reBandit: Random Effects based Online RL algorithm for Reducing Cannabis Use27 Feb 2024
- 2024Monitoring Fidelity of Online Reinforcement Learning Algorithms in Clinical Trials26 Feb 2024
12 newest of 37 All 37 (JSON)